US health officials chased TB carrier around the world

US Features

By Pat Reber May 31, 2007, 13:26 GMT

Washington - In a case that unfolded like a Michael Crichton suspense novel, US health officials trying to corral a drug-resistant strain of tuberculosis chased an infected man around the world during his wedding and honeymoon. Officials at the US Centres for Disease Control and Prevention (CDC) Wednesday described how the Atlanta, Georgia, man had been told he was not to travel overseas or make long plane flights while they tried to determine in early May what kind of TB he suffered. But the patient had 'compelling' reasons to travel to Greece and Rome for his marriage and honeymoon, Dr Martin Cetron, director of the CDC's division of global migration and quarantine, told reporters in broadcast remarks. Racing for the diagnosis, scientists at the CDC determined that the man had an 'extensively drug-resistant tuberculosis' that was immune not only to first-line medical treatment, but also to backup treatments, said Dr Ken Castro, CDC's director of tuberculosis elimination. But the diagnosis apparently wasn't finished before the patient left the country on May 12 on Air France Flight 385 from Atlanta to Paris. The man, reportedly an attorney whose name has not been released, was finally nabbed after he returned to North America and was driving from Montreal to Atlanta in an attempt to circumvent a 'no-fly' order. He was put on a CDC plane in New York City and flown to Atlanta, where he is being isolated under armed guard at Grady Memorial Hospital. The TB case is the first time in more than 40 years that the US government has carried out such a forced isolation under federal law - and an indication of official worry about the spread of such a highly drug-resistant infection. 'We don't take this authority lightly,' Cetron said. Public health officials are focussed on the 'difficult and challenging process' of tracking down 50 to 80 people who sat within two rows of him on the two long, transatlantic flights from Atlanta to Paris and on Czech Air Flight 0104 on May 24 from Prague to Montreal. Cabin crew are also being tested. The duration of passengers' confinement with the patient - more than eight hours - exceeded an international time standard for spread of infectious disease. CDC officials invited passengers on shorter flights within Greece and Europe during the 12-day period to be tested, though authorities said there was not a 'significant risk' of infection. The shorter flights included trips from Paris to Athens, Athens to Tira Island, Mykenos to Athens, Athens to Rome and Rome to Prague. Even those on the more than eight-hour flights were likely not infected, because the 'degree of his infectiousness is quite low,' Cetron said. The man was not coughing up sputum or blood and appeared to be quite healthy, officials said. But tests and follow up tests are needed to make sure. Cetron disputed reports from the man that he had not been forbidden to travel, referring to a family conference held within the Georgia county where the lesion on his lungs was first noted. Frantic efforts were made to track down the man after the drug- resistant TB diagnosis was made, and officials located him through his cell phone during his honeymoon in Rome. 'When we reached him in Rome, one of my quarantine officers made clear that under no uncertain terms should he take a commercial aircraft, and that we were looking at options ... to transport him back to the states,' Cetron said. Efforts with the Italian Health Ministry and airport authorities failed to keep him from leaving Rome. The patient flew from Rome to Prague to Montreal, where he rented a car to begin the drive back to Atlanta. He told the Atlanta Journal-Constitution that he wanted to get home, where he felt he would get better health care. Cetron said he realized the failure to corral the patient indicated shortcomings in the electronic sharing of international flight information and communications with airlines. After the SARS epidemic in Asia and fears of worldwide bird flu in recent years, international health authorities were working on systems to contain the spread of such infectious diseases. Officials said the patient had not violated any laws and was not subject to prosecution for his actions. He will be transferred to the National Jewish Hospital in Denver for further isolation and treatment. The facility has been treating drug-resistant cases for decades, said Dr Charles Daley, an official at the hospital. © 2007 dpa - Deutsche Presse-Agentur

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Diane CroweMay 31st, 2007 - 14:31:12

'Officials said the patient had not violated any laws and was not subject to prosecution for his actions. '

What? This man has put countless people at risk of infection. After being told he should not travel he got on several planes and traveled to several countries putting innocent people including his own family (including his new wife) and friends at risk. Now how much money and time have has to be spent tracking down these people and having them tested? How much inconvenience and fright do these people have to go thru while they wait to see if they've picked up this very serious form of TB? All because one peron couldn't be responsible and change his plans. While it may be unlikely, how will he feel if someone gets sick and dies because of what he did? I think he should be held responsible for his actions.

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